“We need to celebrate our accomplishments with HIV/AIDS globally, but also recognize we can’t declare victory over the disease just yet. We still have a lot of work ahead of us.” – Kevin Fiori, Co-Founder & Chief Strategy Officer
Integrate Health was founded as a result of the AIDS crisis in Togo in 2004. At the time, HIV in West Africa was viewed as a death sentence. Worse still, many women caught the disease from their husbands, yet they bore the brunt of the blame. After these women were widowed, their families would disown them. They were ostracized from the community with no means of economic support and no access to care. Instead of accepting this fate, they resisted it. They fought against the stigma with everything they had to gain access to lifesaving treatment.
Integrate Health works through a local, community-based association of people living with HIV, called AED-Lidaw, to implement HIV programs. Together, Integrate Health and AED have helped to build and scale one of the most effective HIV treatment programs in Togo. The program uses Community Health Workers to provide adherence and psychosocial support to patients in their homes, while physicians, nurses, midwives, and psychologists provide comprehensive medical, psychosocial, and nutritional services to patients in the clinic.
The Integrate Health-supported HIV program doesn’t just save lives; it transforms communities. Those early efforts helped remove the stigma around HIV. They helped empower women infected with HIV to become health workers and advocates themselves. It provided a means for them not only to support themselves, but also to financially contribute to their home, their family, their community. This HIV programming has maintained average adherence rates to antiretroviral therapy over 90%, with 99% of babies born HIV-free through the prevention program.
Community Health Worker Justine Ani works primarily with children as she makes the rounds home to home across rural villages.
She had visited an orphaned child with HIV living with his grandparents. He was a month behind on taking his ARV’s, and no one in the home had picked up the medication or reminded him to do so. After repeated attempts to meet with him, Justine took matters into her own hands and went to the house to deliver the meds. She found him feverish with sores on his skin. Neither he nor his grandparents understood the importance of taking the meds or the full nature of the illness. For many of our CHWs, much of this work involves education. Justine took the time to explain the importance of keeping a medication schedule and not missing treatments.
In Togo, over 11,000 children live with HIV with more than 66,000 children orphaned by AIDS, according to UNICEF. In 2005, Integrate Health and AED-Lidaw launched the first pediatric HIV/AIDS program in Togo. It jump-started a national dialogue about the needs of orphans and vulnerable children. The Integrate Health-supported Pediatric HIV Program provides high-quality, comprehensive care that addresses underlying social and biomedical causes. That means our program provides nutritional, educational, psychosocial, and adherence support to children and their families with the aim of providing the highest possible standard of care.
Integrate Health has supported hundreds of orphans and children living with HIV, offering comprehensive care from school supplies and nutrition kits to enrichment activities and lifesaving antiretroviral therapy (ART). CHWs spend a lot of time making sure that the children understand their circumstances. They are called on to explain to children what their illness entails, the importance of medication, nutrition, and hydration, how to deal with stigma, and other key points during their visits.
Today, Integrate Health supports the largest pediatric HIV/AIDS population in northern Togo, is considered a pediatric HIV/AIDS center of excellence by the Ministry of Health, and serves as a mentor to 20 public health centers to improve pediatric HIV/AIDS care. In 2017, the program treated 13,403 women, children, and people living with HIV; enrolled 1,650 patients on antiretroviral therapy; and had 95% adherence.
PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV:
Approximately 67,000 women of reproductive age in Togo are living with HIV, according to UNICEF. While access to preventative measures can significantly reduce the risk of mother-to-child transmission of HIV, historically only 33% of pregnant women living with HIV in Togo have access.
Since 2005, the Integrate Health-supported Prevention of Mother-to-Child Transmission Program has aimed to eliminate new pediatric HIV infections. Through easy access to care for pregnant women living with HIV along with comprehensive follow-up for them and their partners, we are making great progress. Our programs have led to hundreds of women enrolling in prevention of mother-to-child transmission services. Five years after launching, the Ministry of Health in Togo replicated this program in the regional public hospital.
Today, 99% of babies have been born HIV-free through our prevention program.